What is fifth disease?

Causes and Symptoms

Fifth disease is caused by
infection with the human parvovirus (HPV) B19. The disease is more prevalent during late winter or early spring. Fifth disease is most commonly observed in young children, with the peak attack rate between five and fourteen years of age. Adults may become infected, but they rarely show evidence of disease.

The virus is spread from person to person through nasal secretions or sneezing. Following an incubation period of several days, a rash develops on the face, which has the appearance of slapped cheeks. The bright red color fades as the rash spreads over the rest of the body. An erythematous, pimply eruption may also appear on the trunk or extremities. A mild fever, sore throat, and nasal stuffiness may also be apparent. The rash generally lasts from ten days to two weeks. Often, it will fade only to reappear a short time later. Sunlight may aggravate the skin during this period, also causing a reappearance of the rash.

The diagnosis of fifth disease is primarily clinical, based on the symptoms. Laboratory tests for the virus are generally not performed.

Treatment and Therapy

No antiviral medication is available for fifth disease. Since the disease is rarely serious, treatment is mainly symptomatic, including medications for fever, pain, and itchiness. Bed rest and the administration of liquids, as commonly used in treating mild illness in children, are generally sufficient. Isolation is unnecessary since transmission is unlikely following appearance of the rash.

Perspective and Prospects

Fifth disease was first described during the late nineteenth century as the fifth in the series of erythematous illnesses often encountered by children; the others are measles, mumps, chickenpox, and rubella. HPV B19 was isolated in 1975 and shown to be the etiological agent of the disease in the mid-1980s.

The disease is common and generally benign. HPV B19 has been implicated, however, in certain forms of hemolytic anemias and arthritis in adults, and research continues on the virus.

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"Fifth Disease." MedlinePlus, May 2, 2013.

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Kumar, Vinay, Abul K. Abbas, and Nelson Fausto, eds. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia: Saunders/Elsevier, 2010.

McCoy, Krisha, and Michael Woods. "Fifth Disease." Health Library, Sept. 26, 2012.

"Parvovirus B19 and Fifth Disease." Centers for Disease Control and Prevention, Feb. 14, 2012.

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